Longitudinal respiratory studies in older people

Abstract

Milne, J S (1978).Thorax, 33, 547-554. Longitudinal respiratory studies in older people. A random sample of older people in Edinburgh (215 men, 272 women aged 62-90 years) was examined with the MRC questionnaire on respiratory symptoms. The FEV₁ and FVC were recorded. Spirograms were repeated after one and five years and the questions after five years, the sample by then having been reduced to 133 men and 148 women.

After five years 7% of the surviving men and women had developed persistent cough and phlegm. This syndrome had disappeared in 12% of men and 2% of women. Dyspnoea had increased beyond grade 2 in 13% of men and 7% of women and had lessened only in 6% of women.

One-quarter of male and one-seventh of female cigarette smokers had given up smoking, mostly in the first year. Nearly all who stopped were symptomless before and after. In those men who stopped smoking before the study began symptom prevalence was similar to that in those who continued smoking.

Mean values of FEV₁ and FVC declined as age increased, the decline being greater in FVC with resulting rise in FEV₁%. Five-year differences in FEV₁ and FVC were symmetrically distributed with mean differences increasing with age. Mean differences in FEV₁ were 280-350 ml in men and 150-230 ml in women. Prediction equations from the first examinations remained usable for clinical work. Mean values of FEV₁ and FVC at the first examination were smaller in those who died compared with survivors, whether symptoms were present or not. The prevalence of symptoms was greater in those who died.